Prescription sleeping pills pose morning-after risk for patients

FORT RUCKER, Ala. (January 31, 2013) -- The FDA recently released new guidance for the sleep medication Ambien, and other drugs containing zolpidem, after a report found people who take sleep aids are often still impaired the morning after.

Lyster Army Health Clinic is following the FDA's guidelines and will cut down doses for both men and women.

The requirement safely will cut the recommended dose in half, from 10 milligrams to five milligrams, which will help the body fully metabolize the drug and allow it to leave a person's system before they wake up.

Common side effects are dizziness, nausea and fatigue, which often carry over to the morning and interfere with tasks such as driving or handling machinery. Impairment from sleep drugs can be present despite feeling fully awake. Other side effects include abnormal thoughts or behavior, withdrawal symptoms and panic attacks.

"The medicine can also be addicting and is only suggested as a temporary solution to sleep problems because it affects cognitive and fine-motor skills," said Lt. Col. Sean Hollonbeck, deputy commander for clinical services at Lyster.

Any sleep aid prescribed to a crew member immediately grounds them, he said, adding the list includes pilots, crew chiefs, students and even air traffic control personnel.

"If a prescription sleep pill is administered, it is done so under the direct supervision of the flight surgeon and the unit or flight commander," Hollonbeck said.

For those interested, the Aeromedical Policy Letter, specifically Pre-deployment Rest Agents and Mandatory Disqualifying Medications, explains medications that can ground a patient. The Lyster flight medicine team can clarify any questions.

"In my professional opinion, the use of Ambien has become excessive in our society and I do not feel it solves the problem of sleep disturbance; it just sedates them," Hollonbeck said.

Lyster will not refill prescription sleep aids, but instead will make an appointment for the patient to speak with his or her primary care manager to reevaluate the reason for their sleeping disturbances.

Hollonbeck, who has post-traumatic stress and insomnia, makes sure he exercises routinely, goes to sleep at the same time every night, practices yoga and works to mitigate the stressors in his life.

"I have PTS -- PTS does not mean PTSD -- and sometimes I think about lost friends and bad scenarios. It is part of military life in these times, and it's also common to have PTS in law enforcement jobs and in certain areas of medicine, such as the ER," he said.

Lyster offers alternative solutions to prescription sleep aids such as a sleep hygiene class offered by the behavioral health clinic.

"Prescription sleep aids are a controlled substance and should be treated with the same respect that firearms are given," Hollonbeck said. "The person taking the medication should be accountable and a composite risk analysis should be done for anyone who uses them."